We’ve designed the Teamsters Western Region & Local 177 Health Care Plan (The “Plan”) to make it easy and affordable for Teamster members and their families to access a wide range of health care services. We want to help you be and stay healthy.

We made it easy by:

Once you meet initial eligibility requirements, you are covered.

All of the Plan programs — Medical, Prescription Drug, Dental and Vision—provide access to the same quality network of providers used under the UPS Company Health Plan.

Down the road when it comes time for retirement and you’ve met the eligibility requirements of your pension plan, you’ll continue to receive the industry-leading retiree health coverage through the Plan.

We made it affordable to you and your family by:

Continuing the practice of no member contribution toward monthly premiums;

Keeping your out-of-pocket costs to a minimum; and

Improving upon the company plan by requiring no copay for preventive services such as annual physicals and well childcare.

Medical Coverage

Medical coverage — doctor visits, hospitalization, mammography, x-rays, and the like — is provided for you, your spouse and your dependent children to age 26. The Plan offers access to the very same PPO and HMO medical networks you used and trusted under the UPS Company Health Care Plan. And, as before, the plan you’ll use depends on where you live:

The Aetna PPONetwork is for residents of Arizona, Hawaii, Nevada, New Jersey, New York and Utah (the Aetna PPO for active members is called the Choice POS II);

The Blue Cross Blue Shield PPONetwork is for residents of Alaska, California, Idaho, Montana, New Mexico, Oregon, Pennsylvania and Washington;

Kaiser Permanente HMOis an option for residents of California and Hawaii.

Whichever plan you use, we make taking care of yourself and your family easy and affordable.

Where you live will determine whether you get your medical benefits through the Aetna or Blue Cross Blue Shield PPO. Both plans cover the same services at the same costs. The only difference between them is their provider network. When you stay in-network, there are no forms to file, no need for a referral to see a specialist, and no need to designate a primary care physician. Preferred Provider Organizations are medical networks that offer both great value and flexibility. The providers included in a PPO have agreed to accept the Plan’s pre-negotiated rates for services. As long as you stay within the network, you won’t be billed in excess of the negotiated amount for covered services. (No "balance billing.") You can choose to visit a provider who does not participate in the network and you’ll still receive coverage, but if you do, you’ll likely pay more out-of-pocket for services.

Your Cost In-Network

Out-of-Network Cost

Annual Deductible

NO annual deductible in the first four years of the contract (2014-2017). In the fifth year (effective Jan. 1, 2018), there is a modest, one-time annual deductible of $100 for individual coverage and $200 for family coverage.

Annual Out-of-Pocket Maximum

$1,000 per person/$2,000 per family

No maximum

Preventive Care

Routine Physical Exam

No cost to you; Plan pays 100%

Not covered

Well-Child Care

No cost to you; Plan pays 100%

Not covered

Mammograms

No cost to you; Plan pays 100%

Not covered

Routine GYN Exam

No cost to you; Plan pays 100%

Not covered

Outpatient Care

Physician’s Office Visit

$10 copay

Plan pays 70%; you pay 30%

Chiropractic Care

(12 visits per year)

Plan pays 80%; you pay 20%

Plan pays 70%; you pay 30%

Outpatient Surgery

No cost to you; Plan pays 100%

Plan pays 90%; you pay 10%

X-Ray and Lab Tests

No cost to you; Plan pays 100%

Plan pays 70%; you pay 30%

Inpatient Care

Inpatient Hospitalization

No cost to you; Plan pays 100%

Plan pays 90%; you pay 10%

Inpatient Surgery

No cost to you; Plan pays 100%

Plan pays 90%; you pay 10%

Emergency Care

Emergency Room

Plan pays 100% if admitted or within 24 hours of an accident; otherwise, you pay 20%

Important: For services that are covered out-of-network, you are responsible or your coinsurance, plus any amounts your provider changes above what the Plan considers reasonable and customary.

Did You Know?

Many routine preventive care services are covered at 100%. Take advantage and make sure to schedule your routine exams and screenings!

Residents of California can opt to participate in either the Blue Cross Blue Shield PPO or the Kaiser California HMO Plan. Likewise, those in Hawaii have a choice of either the Aetna PPO or the Kaiser Hawaii Plan. UPS Teamsters currently enrolled in the Kaiser Permanente network will see no change in their health care benefits. For members new to the Kaiser HMO, all of your coverage—including prescription drugs— is coordinated through Kaiser doctors and facilities. Central coordination is a common practice in HMOs such as Kaiser. While most care is coordinated through your primary care physician, Kaiser allows direct access to some specialty services, including OB/GYN, well-woman visits, outpatient mental health/conduct disorder, Pediatrics, Optometry, Dermatology and Ophthalmology (varies among medical centers). In addition to these specialists, members may also self-refer to certain diagnostic services such as mammography, pregnancy testing, and blood sugar testing. The Kaiser plans in California and Hawaii differ slightly in terms of out-of-pocket costs. In both states, Kaiser does not cover non-emergency out-of-network coverage.

Kaiser of California Your Cost In-Network

Kaiser of Hawaii Your Cost In-Network

Annual Deductible

None

None

Annual Out-of-Pocket Maximum

$1,500 per person/$3,000 per family

$1,500 per person/$4,500 per family

Preventive Care

Routine Physical Exam

No cost to you; Plan pays 100%

No cost to you; Plan pays 100%

Well-Child Care

No cost to you; Plan pays 100%

No cost to you; Plan pays 100%

Routine GYN Exam

No cost to you; Plan pays 100%

No cost to you; Plan pays 100%

Mammograms

No cost to you; Plan pays 100%

No cost to you; Plan pays 100%

Outpatient Care

Physician’s Office Visit

$5 copay

$14 copay

Chiropractic Care

$5 copay up to 20 visits per year

$14 copay up to 30 visits per year

Outpatient Surgery

$5 copay per encounter

$14 per encounter

X-Ray and Lab Tests

No cost to you; Plan pays 100%

$14 per department per day

Inpatient Care

Inpatient Hospitalization

No cost to you; Plan pays 100%

No cost to you; Plan pays 100%

Inpatient Surgery

No cost to you; Plan pays 100%

No cost to you; Plan pays 100%

Emergency Care

Emergency Room

$5 copay per visit; Plan pays 100% if admitted

$25 copay per visit; Plan pays 100% if admitted

FAQs

What Copayments will I be responsible for?

For participants in the Aetna and Blue Cross Blue Shield networks, the copayments for medical office visits, routine physicals, well child care, routine mammograms, routine OB/GYN are for the most part the same under the new plan as you paid under the UPS Company Health Care Plan.